Removing ovaries during hysterectomies protects against future risk of ovarian cancer but the ovaries and the hormones they produce may have advantages for preventing heart disease, hip fracture, sexual dysfunction, and cognitive decline. Outside cancer risk, the most important factor that should determine ovarian conservation vs. removal is her age- whether she is older or younger than 50 - according to a review article published in Journal of Women's Health.

Women have a choice between ovarian conservation or removal but wide variations in recommendations, and therefore practice patterns, exist. Conflicting data regarding the potential benefits of removing a woman's healthy ovaries at the time of a hysterectomy have led to confusion, notes Catherine A. Matthews, MD in the Department of Obstetrics and Gynecology, University of North Carolina - Chapel Hill.

When there is no acute reason to remove a woman's ovaries at the time of hysterectomy and she has no increased genetic risk for ovarian cancer, the accumulated data Matthews analyzed indicates that elective bilateral ovary removal should be discouraged in women younger than 50 years. 

The withdrawal of ovarian hormones can have negative health consequences in this population. However, in postmenopausal women, it is advisable to remove the ovaries to protect against ovarian cancer, as the medical literature shows that elective ovary removal is not likely to have an adverse effect on heart disease, hip fracture, sexual dysfunction, or cognitive function at this stage of a woman's life.

Citation: Catherine A. Matthews, MD, 'A Critical Evaluation of the Evidence for Ovarian Conservation Versus Removal at the Time of Hysterectomy for Benign Disease', Journal of Women's Health doi:10.1089/jwh.2013.4259